Tuesday, July 28, 2020
If you can keep your head...
Here's how it went down this morning.
It was 0126 when I woke up with a bad cough. I mean a bad cough, a full bore flu cough. The kind that hurts when you cough, like someone is tearing at your bronchi with sandpaper encrusted fingers. I had a pounding headache and a sore throat and I felt really sick and really weak.
Fuck, I thought. Is this the fucking wuhandromeda shit?
Of course that's the first thing I thought, given the current planetary covid psychosis infecting seemingly everyone.
On the one hand, I had reason for legitimate concern. While the symptoms were solidly consistent with a bad case of influenza, the onset of this thing was different than any flu I'd ever had or heard about. In my personal experience flu symptoms come on gradually over many hours or even a day or two. My clinical training and experience echo this. A person's immune system ramps up to fight the viral invaders while at the same time the virus numbers are growing as they transform healthy cells into virus factories and grow the viral population exponentially. The body becomes a battleground, and the symptoms the infected person experiences -- fever, chills, aches, fatigue, cough, sore throat, headache -- those symptoms are nearly all caused by the toxicity of cellular destruction and decomposition.
The sudden onset of severe upper respiratory symptoms was very, well, wrong. Influenza doesn't work like that. But what if covid does? Fuck.
In addition to a painful cough, there was a good bit of panic bubbling up in my chest. Fuck. Fuck-fuck-fuck-fucktards!
Okay, deep cleansing breath (complete with painful, wracking cough). Think! Scale, context, perspective! Time for an objective assessment.
When seeing a patient in a clinical, field, or emergency setting you generally follow the SOAP format. Subjective, Objective, Assessment, Plan. Subjective is what the patient says. Objective is what you observe, including vital signs, exam, labs, images, etc. Assessment is basically a working diagnosis. Plan is what you and the patient decide to do about the malady or injury.
Subjectively I feel like shit. I feel really sick. Cough, headache, sore throat, aches and pains, fatigue, malaise.
What's going on objectively though? Yes, I'm coughing, I hurt, I feel terrible. So, vital signs. B/P is 118/77, pulse 65. A pulse of 65 is almost certainly too low for a person with a raging viral infection. Hmmm. Temperature? Hey, it's 97.9. That doesn't fit either. Hmmm squared. And frankly, the sudden onset is wrong for a viral URI. Hmmm cubed.
In the midst of this I have a call in to the VA in Cheyenne. My reasoning when I dialed the number and joined the perma-hold queue was that I should be tested for the fancy new wuhandromeda strain. On its face, not a terrible idea. Except for a couple of things.
Firstly, do I have confidence in the tests? As best I can tell, the present iteration of test kits have a 50 percent false positive rate. So no, I have no confidence in potential test results.
Secondly, would an actual correct test result change any potential treatment plan? No. Treatment for everyone with symptoms if influenza is almost entirely supportive. Anti-virals (tamiflu, a stab in the dark), mucolytics (guaifenisin/mucinex), analgesic/antipyritic (tylenol), fluids, rest, airway support if needed, antibiotics if a secondary bacterial infection shows up, etc. So positive or negative test, same treatment plan.
Thirdly, I'm not liking the politics/ideology of this pseudo-pandemic. I don't really want to be a data point used primarily to grow political/government power when a so-called emergency pandemic situation has prompted an abandonment of objective medical science and Constitutional protections.
As I reach for my phone to end the call, someone rogers up. Fuck.
As the conversation develops I'm thinking. If I have influenza -- whether it's wuhandromeda or not -- it's going to be up to my immune system to prevail or fail. I'm in very good shape and there's not a thing wrong with my immune system, as far as I know. One thing that might help is a course of antivirals. The science is sketchy on this, but the potential positive probably outweighs the potential negative. In other words, even if it doesn't really help it probably won't hurt.
The plan becomes this. I'll take tylenol and mucinex right now (it's just gone 0200) and at 0600 I'll push on over to Cheyenne, where the VA minions will be prepared to test me for wuhandromeda, assess my illness, and treat it more or less appropriately (I hope!).
At 0600 I'm feeling better. The cough and sore throat are mostly gone. I still feel significant fatigue and malaise, but overall I seem to be miraculously healing myself. So what the fuck?
Then I remember. Last evening I was participating in a meeting when the olden florescent lights begin to fail Soon the room is filled with the stench of dying 1950's era ballast. It's quite an unpleasant odor, but we were in the middle of something important so we all hang in there for another 30 minutes to resolve the problem we were working. The lights were turned off and the stench slowly subsided. When we were done it was very good to get outside and into the fresh air. I head home and hit the sack, electrical outgassing completely forgotten.
Well, shit. Smoke/gas inhalation fits the symptoms better than regular or wuhandromeda influenza.
Nevertheless, I decide to press on over to Cheyenne. I'd like to get a real physician to giggle check my diagnosis. If I get a pretend physician I can always leave. My assessment of the chances of getting a real physician doing real physician stuff -- based on my direct experience -- is about one in five. Maybe one in ten. We'll see.
Cut to the chase, and I'm probably right. My vitals, labs, and x-rays are clean, with two exceptions. The wuhandromeda test will take five to nine million government working days. It's unlikely to be positive though, and if positive it's unlikely to be really positive. Also, the microscopic exam of my sputum (coughed up lung stuff) revealed "particulates consistent with mild to moderate smoke inhalation."
I find it illuminating that my initial reaction to waking up sick and coughing was to fear the magic wuhandromeda strain. At least I was able to work through my fears and near-panic and emerge unscathed.
So there you have it. Probably not wuhandromeda. Certainly smoke inhalation. As of writing this I'm still coughing up junk but feeling enormously better. So much better that...
Okay. I just put a Barska 4x BDC scope on the Colt LEC (Law Enforcement Carbine). It's a good zombie gun, and with the Barska mounted on the carry handle I can use either the irons or the scope. So the thing needs sighted in. Duh.
Can I still shoot?
A bit tricky to sight in today...
Not all that bad on the results though...
Could be worse.
Love it when a plan comes together...
Sighted in and reasonably happy with the rifle and my marksmanship, and also feeling a thousand percent better than I did at 0126, I decide to hump it. I'm rocking a different tactical vest today but still have the same basic 40 pound load. Ammo, water, survival shit, rifle, pistol.
I was still coughing up junk. So what? A good lung workout was called for, something to get lots of air moving in and out and force the lungs to purge all foreign particulates.
So I did 2.72 miles in 40 minutes.
It was a good hike on a beautiful day. Hills. Lots of hills. That gave everything a lovely workout, including the lungs, which did just fine.
As the day begins to wind down, what sucked at the beginning has morphed into a life experience to embrace.
Be well and embrace the blessings of liberty.